中华小儿外科杂志
中華小兒外科雜誌
중화소인외과잡지
CHINESE JOURNAL OF PEDIATRIC SURGERY
2012年
9期
692-694
,共3页
张娜%曾骐%陈诚豪%于洁
張娜%曾騏%陳誠豪%于潔
장나%증기%진성호%우길
漏斗胸%复发%治疗
漏鬥胸%複髮%治療
루두흉%복발%치료
Funnel chest%Recurrence%Therapy
目的 探讨漏斗胸手术后复发的原因,再手术方法的选择和相关临床经验.方法 回顾性分析1996年1月至2010年11月手术治疗113例次复发性漏斗胸,共110例患儿的临床资料.其中,翻转法13例,截骨加外同定5例,截骨加内固定59例,悬吊法4例,Nuss法32例.再手术方法:翻转法2例,截骨加内固定15例,Nuss法71例,Nuss加截骨25例.结果 113例均顺利完成手术,手术时间30～420 min.随访1个月～14年,3例截骨加内固定术后再次复发,再行Nuss加截骨手术治疗.结论 马凡综合征、神经纤维瘤病等骨质异常以及短期内生长过快是漏斗胸复发的内在因素;手术方式的选择及手术操作不当、支撑力量、时间不够是漏斗胸复发的外在因素.Nuss手术和Nuss加截骨是目前复发漏斗胸的最佳手术方法.远期效果的评价,还需进一步研究探讨.
目的 探討漏鬥胸手術後複髮的原因,再手術方法的選擇和相關臨床經驗.方法 迴顧性分析1996年1月至2010年11月手術治療113例次複髮性漏鬥胸,共110例患兒的臨床資料.其中,翻轉法13例,截骨加外同定5例,截骨加內固定59例,懸弔法4例,Nuss法32例.再手術方法:翻轉法2例,截骨加內固定15例,Nuss法71例,Nuss加截骨25例.結果 113例均順利完成手術,手術時間30～420 min.隨訪1箇月～14年,3例截骨加內固定術後再次複髮,再行Nuss加截骨手術治療.結論 馬凡綜閤徵、神經纖維瘤病等骨質異常以及短期內生長過快是漏鬥胸複髮的內在因素;手術方式的選擇及手術操作不噹、支撐力量、時間不夠是漏鬥胸複髮的外在因素.Nuss手術和Nuss加截骨是目前複髮漏鬥胸的最佳手術方法.遠期效果的評價,還需進一步研究探討.
목적 탐토루두흉수술후복발적원인,재수술방법적선택화상관림상경험.방법 회고성분석1996년1월지2010년11월수술치료113례차복발성루두흉,공110례환인적림상자료.기중,번전법13례,절골가외동정5례,절골가내고정59례,현조법4례,Nuss법32례.재수술방법:번전법2례,절골가내고정15례,Nuss법71례,Nuss가절골25례.결과 113례균순리완성수술,수술시간30～420 min.수방1개월～14년,3례절골가내고정술후재차복발,재행Nuss가절골수술치료.결론 마범종합정、신경섬유류병등골질이상이급단기내생장과쾌시루두흉복발적내재인소;수술방식적선택급수술조작불당、지탱역량、시간불구시루두흉복발적외재인소.Nuss수술화Nuss가절골시목전복발루두흉적최가수술방법.원기효과적평개,환수진일보연구탐토.
Objective To discuss causes for recurrent pectus excavatum and summarize our experiences in secondary pectus excavatum repairs.Methods Total 113 cases(3 of them were repaired twice) underwent procedures from January 1996 to November 2010 in our center and 110 of them were followed up.The original procedures included Ravitch procedures in 13,osteotomy combined external fixation in 5,osteotomy combined internal fixation in 59,and suspension technique in 4,as well as NUSS procedure in 32.The secondary procedures include Ravitch procedures in 2,osteotomy combined internal fixation in 15,NUSS procedures in 71,and NUSS combined osteotomy in 25.Results All patients were done successfully and 3 cases recurred after osteotomy combined internal fixation.They underwent secondary operation (NUSS combined osteotomy).The operation time ranged from 30 to 420 minutes.Conclusions The internal causes of recurrent pectus excavatum include Marfan syndrome,neurofibromatosis which may lead the disorder of sclerotic and over-growth.The external causes include unsuitable technique,uncorrected procedure,poor pedestal strength and less time to support to sternum.NUSS procedure、NUSS combined osteotomy procedure are the effect techniques to repair recurrent pectus excavatum.However,lone term of efficacy evaluation is still needed.
